Order Form for Pasadena Institute Products
(print out and mail or fax to: 626-798-2625
or mail to: Pasadena Institute for Relationships
2388 N. Altadena Dr., Altadena, CA 91001
Questions: Call 626-798-5242)
Name
Address
City State Zip
Phone Number
|
Medium |
Title |
Price |
Quantity |
Tax 8.25% if in CA |
Shipping/ Handling in the U.S. |
Total |
| DVD | "Dance of Infidelity"** NEWLY REDUCED PRICE!!! | $49.00 | $3.20 | |||
| DVD | "Behind Closed Doors"** | $99.00 | $3.20 | |||
| DVD | "Demonstration of Imago Dialogue"** | $29.00 | $2.00 | |||
| Book | "Raising Cooperative & Self-Confident Children" | $15.00 | $3.00 | |||
| Cassette | "Raising Cooperative & Self-Confident Children" | $16.00 | $3.20 | |||
| CD | "Raising Cooperative & Self-Confident Children" | $16.00 | $3.20 | |||
| Book Wholesale | "Raising Cooperative & Self-Confident Children" (Minimum order: 4, Sales tax not applicable) | $10.00 ea | $5.00 for the first 4, + $1 for each one over 4 | |||
| Cassette Wholesale | "Raising Cooperative & Self-Confident Children" (Minimum order: 4, Sales tax not applicable) | $11.00 ea | $5.00 for the first 4, + $1 for each one over 4 | |||
| CD Wholesale | "Raising Cooperative & Self-Confident Children" (Minimum order: 4, Sales tax not applicable) |
$11.00 ea |
$5.00 for the first 4, + $1 for each one over 4 | |||
| Book | "Le Couple: Mode d'Emploi | $26.95 | $3.50 | |||
| Grand Total |
For DVD Orders only
**License # in Imago Directory (Circle one) Yes No
(If "yes" to Imago Directory no need to include license number. If "no", please include copy of license with this order form.)
Method of Payment (Circle one): Visa M/C Check (Make out to: Pasadena Institute)
Name as it appears on Card:
Shipping Notes/Questions: